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.� <br /> �$1�9�`�' �� CAI.C�.3���'I�_N <br /> 1, 1.25�I� of� CR�.r��t YC'�.L�* or �%U.�lll�dn_�..��4� <br /> � �j:��:.. �- � �_._. x ��l 25 � --�_.�� _------- <br /> (cacu�act price) <br /> `l. �� ��r&ha��� ** Add the State U��ilding Cade �ivisian <br /> � ,�urcharge to each perrnit. .m..� � _._.. x .()()�5 � ____m�...._�___�..�_.�..._.�. <br /> (co��trac;t prlcc) <br /> ��r $.g0, whichev�r is �ra�ter <br /> 3, Po�ta�� and�,�,�$ (Qn1y mai�•i�i a�aplicatians) $ , , 1.�?______�., <br /> 4, Tp'1'AI.. Pk�tM.I7' F�E (Add ii;-�cs 1-3 above) � . - ��.___._ <br /> " C'C7N7'�tA.C'T PFtICE or 1Q8 COST 1�aeans th:a^tual or esiimatei! dattar amount char$ed Yor the permitted <br /> w��rk includin� matcri�ls, tabor, prafit, ai�d �°hcr �xed costs. !t is the amaunt tu be charged tn th� <br /> customer fc�r thG wo�k done. !t any ma��srial, srt,ipment, labor,��r inst�llation are fi�rnishe:d by the awncr, <br /> ten�nt ar any at�er �ar�y Ihe reasanaUl�• ma�k�. •�zlue c�f yu�.h items must bu added to tha e�tirnnted cosc <br /> ar cUntr�Gt price for p�rmit tcc pucpose:',. ln t,�e:..�cnC t,hat there is a clispute on the amount af Ih�jt�b c;ost, <br /> the C'i[y t�ay request th� submisaion n, a �i&n,:ti' copy of the actual contraCt. <br /> ** The STATE SURCHARC3E ts .(�1U5 c,-f the euntract priC� under $t,0U0,Of.}0 or $.SQ - wUicbever is <br /> gr�ater. For v�ivatians uvcr �1,OQc),0:Q cali the D�p;trtment of Inspectionul Sat'vices for the price, <br /> The unc��rsigned hereby upplies to thc City f�: lssu�nce of a Piumhin� Pernlit, agre�s to da all <br /> wot�k i�a stric;t xcc.orc�ance with the ordi�iance� ��f the City and the regulati�ns of the State uf <br /> Minn��cytd, and ccrtifie� that all statementE: �nade on this applicatiQn are cotnplete, true and <br /> c�rCeci. <br /> . � <br /> ? =� , <br /> �►p�ticant's 5i�nature: ��:...�:�?-r1��.-� ��I-�"��._� Date: ��?-"�-��'.�_`'� / <br /> I ` - �� <br />